UP TO 700 people may have been killed in an earthquake which destroyed thousands of homes and wiped out entire villages in a remote province in Pakistan, doctors have warned.

The doctor in charge of the largest hospital close to the epicentre in Balochistan province said his staff were working in chaotic conditions and with poor facilities to save lives but many victims remain stranded in remote villages beyond the reach of the rescue services.

"It's a complete chaos here at the hospital. And we do not have 4x4 ambulances, so it's really tough to reach out to the affected areas," said Dr Noor Baksh Bizenjo, medical superintendent of the district hospital in Arawan.

Pakistan's National Disaster Management Authority (NDMA) confirmed the official death toll had reached 328, with 445 injured being treated at medical facilities, 190 of whom are in a critical condition.

DESTRUCTION

Brigadier Mirza Kamran Zia, director of the NDMA, said it would be three days before rescue specialists were able to reach all the affected areas and assess the full scale of the destruction. Army rescue units are trying to cover 8,000 square miles of one of Pakistan's most remote regions.

"We just can't say how many homes were destroyed. Most of the homes were very small mud houses. In some areas, entire villages . . . have been razed to the ground," he said.

The earthquake was of greater magnitude – 7.8 – than the 2005 quake which killed 100,000 people and displaced 3.5 million from their homes along Pakistan's north-west frontier and into India's Jammu and Kashmir state.

The first tremors were felt at 4.29pm on Tuesday and caused buildings to shake in Karachi, the Baloch capital Quetta, towns throughout Balochistan and Sindhi and as far away as Delhi and Dubai.

Casualties are expected to be far fewer than in 2005 because the affected area is remote and sparsely populated with little infrastructure.

Officials said 30pc of homes in Awaran district had been destroyed, but some districts had lost 90pc of their buildings.

Images broadcast on Pakistani TV showed lifeless children laid out on the back of a truck, and homes reduced to mud bricks and dust.